Addressing the Millennium Development Goals (MDGs) in Africa "will not only require extra spending, but also better spending," as well as the improvement of social services and priority setting, Kingsley Alu writes in a Leadership column. "Although the MDGs may appear affordable at the global level, it must be stressed that many governments in Africa will be hard pressed to meet the financial requirements for achieving the targets by 2015," he writes in the Nigerian newspaper.

Noting that each MDG target will be met by some countries, "including a few low-income countries," he adds: "If these countries can achieve the MDGs, there is no reason why others cannot." The column outlines impediments to achieving the goals including ignorance around HIV/AIDS, lack of good education, which "will undermine the chances of reaching the other MDGs." Alu also notes that "[o]fficial development assistance (ODA) and debt relief will be indispensable."

"But while the MDGs remain unfulfilled, they also remain feasible and affordable. Committed leadership, stronger partnerships, extra resources, and deeper participation by the poor can bring the world back on track towards the MDGs. It is not too late to realise the dream by 2015," Alu concludes (10/19).

'Keep Things Working' In Developing Countries

A post by authors Tina Rosenberg and David Bornstein on the New York Times' "Opinionator" blog examines why "many diseases that we know how to prevent and cure remain widespread," and offers an example of "one solution" by profiling Riders for Health, a British organization that maintains motorcycles in Africa. The post profiles a Lesotho health assistant, Tsepo Kotelo, who now cares for 20 villages instead of three after receiving a motorcycle from the Elton John AIDS Foundation.

"There's nothing new about donating vehicles for health care in Africa. Many organizations do it. But often these vehicles fall apart," the authors write, noting that unmaintained vehicles in Africa often breakdown after 8 months and are thrown away after 15. "This is a classic problem in development: everybody wants to play the white knight coming to the rescue with the quick fix  the water pump, the $100 laptop, the motorcycle. But the tougher challenge is developing a cost-effective system to keep things working."

In addition to visiting more villages, the authors write, "Kotelo can also respond to emergencies, so he can provide better care as well as more of it. And visiting villages more frequently, he can catch illnesses in their early stages or prevent them entirely. A woman with a breach baby can make it to the hospital in time  by sidecar ambulance, no wheelbarrow necessary. People now give sputum samples for TB diagnoses because they trust that their samples will actually reach the laboratory unspoiled. All these changes save lives." By focusing on motorcycle maintenance, Riders for Health "dramatizes the importance of paying attention to the scruffy and mundane parts of a system, especially delivery" (10/18).

U.S. Involvement In Global Effort To Eliminate Polio

A VOA News editorial presents the U.S. government's view on efforts to eradicate polio. The editorial notes the U.S.'s work with the Organization of the Islamic Conference, or OIC, "to support affected countries to vaccinate children and establish robust disease surveillance systems, to increase community awareness about the safety and importance of immunization and to identify new sources of funding to close the resource gap."

"Since the Global Polio Eradication Initiative began, the U.S. has provided $1.8 billion in funding, as well as extensive technical support from the Centers for Disease Control and Prevention and the U.S. Agency for International Development. As well, polio eradication is a component of President Obama's Global Health Initiative," the editorial states.

The editorial quotes U.S. Special Envoy to the OIC Rashad Hussain, who said: "For the Obama Administration, the eradication of polio is a key foreign policy objective ... Polio is a fully preventable disease, one for which we have had the expertise and technology to address for decades." Hussain added, "This last push will require renewed international commitment, cooperation and community involvement" (10/16).

Despite Increased Pledges, Commitment To Global Fund Not Enough

"Even in the midst of an economic downturn, the United States and other donors have increased their pledges to a global fund that is fighting three of the world's most devastating infectious diseases. Unfortunately, the money will not be nearly enough to meet the rising health needs in developing countries," states a New York Times editorial. "No other donor nation came close to" the U.S. percentage increase, according to the editorial, which notes the U.S. pledge of "$4 billion over three years, a 38 percent increase over the preceding three years."

Unless additional financing can be found, the editorial continues, "[m]illions of lives that could be saved will be lost." Though the money pledged will be enough to continue existing initiatives and allow $2.9 billion to add new programs, "[t]he disappointing fact is that the rate at which the fund has been expanding its work will be greatly slowed."

Noting that continuing the existing rate of expansion would cost $17 billion, the editorial concludes, "The Global Fund and advocacy groups need to press countries that have not yet pledged or pledged too little to ante up. Congress is on track to approve $1.1 billion or slightly more for fiscal-year 2011, which is more than what President Obama requested. It should consider whether it can give more. This effort is essential for global health and the stability of fragile nations" (10/15).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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